How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,072 to $11,220Professionalmedian $1,380 · 10th to 90th $513 to $2,884
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $512.86 Median $6,456.54 Typical High $14,454.40 | Facility | None | $512.86 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $4,677.35 | Professional | None | $512.86 | $512.86 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $1,548.82 Typical High $3,162.28 | Professional | None | $436.52 | $1,548.82 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,995.26 Typical High $5,754.40 | Facility | None | $977.24 | $1,995.26 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,202.26 Typical High $2,089.30 | Professional | None | $660.69 | $1,202.26 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $446.68 Median $7,943.28 Typical High $14,791.08 | Facility | None | $446.68 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,318.26 | Professional | None | $812.83 | $1,000.00 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $10,964.78 | Facility | None | $758.58 | $4,466.84 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,348.96 Typical High $2,238.72 | Professional | None | $512.86 | $1,348.96 | $2,238.72 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,818.38 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,698.24 | Professional | None | $562.34 | $954.99 | $1,698.24 |
Prevea360 Setting Facility Modifier None Typical Low $346.74 Median $446.68 Typical High $831.76 | Facility | None | $346.74 | $446.68 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $398.11 Median $912.01 Typical High $1,737.80 | Professional | None | $398.11 | $912.01 | $1,737.80 |
Quartz Setting Facility Modifier None Typical Low $831.76 Median $3,801.89 Typical High $6,456.54 | Facility | None | $831.76 | $3,801.89 | $6,456.54 |
Quartz Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | None | $660.69 | $660.69 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Security Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,630.27 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,380.38 Typical High $2,137.96 | Professional | None | $446.68 | $1,380.38 | $2,137.96 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $2,344.23 | Professional | 52 · Reduced service | $251.19 | $251.19 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $933.25 | Professional | 53 · Discontinued | $102.33 | $102.33 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $3,467.37 | Professional | 54 · Surgery only | $380.19 | $380.19 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $691.83 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $467.74 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $3,235.94 |
Where Wisconsin sits
The same service costs 5.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 4th of 51
$1,995
AK $2,188KY $398
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.